Healthcare Provider Details

I. General information

NPI: 1730881210
Provider Name (Legal Business Name): YARDEN ORA GOLDMAN GOLLAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 S SEACREST BLVD
BOYNTON BEACH FL
33435-7969
US

IV. Provider business mailing address

2815 S SEACREST BLVD
BOYNTON BEACH FL
33435-7969
US

V. Phone/Fax

Practice location:
  • Phone: 800-424-3672
  • Fax:
Mailing address:
  • Phone: 800-424-3672
  • Fax: 954-377-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME183267
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: